13 November 2014

Durban has highest HIV rate among MSM

A study found that Durban had the most men who have sex with men (MSM) testing positive for HIV, compared to Johannesburg and Cape Town.


Men who have sex with men have a high prevalence of HIV, with Durban having the most men testing positive for the virus compared to Johannesburg and Cape Town, a study has found.

Marang Men's Project

"In Durban, the prevalence was unusually high among respondents at 48.2 percent, in Cape Town, the overall prevalence was 22.3 percent. Johannesburg was at 26.8 percent," the researchers at the Human Sciences Research Council said.

The study, called the Marang Men's Project, was conducted from 2012 to 2013 in Johannesburg, Cape Town, and Durban among 925 men who have sex with men (MSM).

The term "men who have sex with men" (MSM) refers to "all biological males who have sex with other biological males, irrespective of the person’s sexual orientation and gender expression", the authors of the study pointed out.

Read: Secret bisexuality takes mental toll

In other words, MSM does not only refer to gay men, but also to bisexual men, some in stable heterosexual relationships.

Professor Thomas Rehle, one of the researchers, said the study confirmed that men who had sex with men faced a risk of being infected with HIV.

Unprotected anal intercourse put the men at increased risk of HIV infection.

Regular male partner

"The findings provide much needed information to guide relevant policy development which may ultimately improve uptake of services among MSM," he said.

Concerning regular sex partnerships, more than 60 percent in the three cities reported having a regular male partner in the last six months.

In comparison, 16 percent of respondents in Cape Town, 2.8 in Durban, and 38.7 in Johannesburg reported having a regular female sex partner in the last six months.

In each of the three cities, more than half of all respondents reported that they had sex with three or more male partners in the last six months.

Read: More syphilis among gay and bisexual men

The association between alcohol use before sex and HIV infection had been highlighted by various studies conducted among men and women in the general population, the researchers said.

"In this study, a few of the respondents (seven to 16 percent) in each of the three cities reported ‘always’ engaging in sexual intercourse after consuming alcohol."

Condoms not used correctly

Engaging in either selling or buying sex (transactional sex) is a risk for HIV infection, especially when condoms were not used correctly and consistently during sex.

"Over half of the respondents – 52.6 percent in Cape Town, 11.4 in Durban, and 23.1 in Johannesburg reported that they had ‘sold sex to men’ in the last six months."

According to the study, HIV is rampant in prisons because of the cramped single-sex living conditions and prolonged periods of being locked up in overcrowded cells, which are believed to promote casual or forced same sex sexual relations among men, mostly involving anal sex.

Read: Discrimination of black gay men ups anxiety

The researchers' recommendations included a comprehensive national HIV prevention programme for MSM that entailed targeted HIV prevention, care, treatment, and counselling services.

Another recommendation was the mainstreaming of HIV prevention messaging to address not only HIV prevention for gay men but also for men who did not necessarily identify themselves as openly gay, but also engaged in MSM behaviour.

Read more:

When sexual health requires stealth
HIV rife among Asian men
1 in 5 gay men in US cities has HIV

Image: Men about to kiss from Shutterstock


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Dr Sindisiwe van Zyl qualified at the University of Pretoria in 2005. She is a patients' rights activist and loves using social media to teach about HIV. She is in private practice in Johannesburg.

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